Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.5944
Peer-review started: July 30, 2020
First decision: August 22, 2020
Revised: September 5, 2020
Accepted: October 13, 2020
Article in press: October 13, 2020
Published online: December 6, 2020
Processing time: 127 Days and 0 Hours
Hernia is a common condition requiring abdominal surgery. The current standard treatment for hernia is tension-free repair using meshes. Globally, more than 200 new types of meshes are licensed each year. However, their clinical applications are associated with a series of complications, such as recurrence and infection, leading to a bottleneck in the development of hernia repair surgery techniques. Statistics show that the recurrence rate after hernia repair surgery ranges from 10% to 24%, and postoperative mesh infection rate ranges from 0.5% to 9.0%.
The existing drawback has led to the advent of 3D-printed meshes. Since their emergence, 3D-printed meshes have significantly reduced postoperative complications in patients. They have also shortened operating time and minimized the loss of mesh materials. However, it is difficult to obtain accurate data of the pectineal foramen before surgery. This study aims to find a simple, effective, non-invasive and accurate method to provide data support for the production of 3D-printed mesh.
The purpose of the present study was to conduct statistical analysis of the myopectineal orifice (MPO) data obtained from preoperative computer tomography (CT)-based 3D reconstruction and real-world intraoperative measurements so as to identify the differences between them and determine whether the CT-based 3D reconstruction technique can be an ideal method to obtain precise data for the production of 3D-printed biologic meshes.
This was a retrospective analysis of 60 patients who underwent laparoscopic tension-free repair for inguinal hernia in the Department of General Surgery of the First Hospital of Shanxi Medical University from September 2019 to December 2019. This study included 30 males and 30 females, with a mean age of 40 ± 5.6 years. Data on the MPO were obtained from preoperative CT-based 3D reconstruction as well as from real-world intraoperative measurements for all patients. All preoperative and intraoperative data were analyzed using the t test. Differences with P < 0.05 were considered significant in comparative analysis.
The distance between points AB, AC, BC, DE, and AE based on preoperative and intraoperative data was 7.576 ± 0.212 cm vs 7.573 ± 0.266 cm, 7.627 ± 0.212 cm vs 7.627 ± 0.212 cm, 7.677 ± 0.229 cm vs 7.567 ± 0.786 cm, 7.589 ± 0.204 cm vs 7.512 ± 0.21 cm, and 7.617 ± 0.231 cm vs 7.582 ± 0.189 cm, respectively. All differences were not statistically significant (P > 0.05).
The use of multislice spiral CT-based 3D reconstruction technique before hernia repair surgery allows accurate measurement of data and relationships of different anatomic sites in the MPO region. This technique can provide precise data for the production of 3D-printed biologic meshes.
Specifically in hernia repair surgery, the use of 3D-printed biologic meshes has drawn increasing attention due to their demonstrated advantages, such as low recurrence rate, infection rate, and frequency of adverse reactions and rapid integration with the body. The first step of 3D-printed biologic mesh production is based on CT-based 3D reconstruction, i.e., generation of stereoscopic images of the MPO and defect sites for data analysis, which allows the CT-based 3D reconstruction technique to become an ideal measurement method that can rapidly provide precise data to support the production of 3D-printed biologic meshes.